1. Systems for health

“I want all doctors in Wyoming to internalize population health management,” says James Bush, MD, Medical Officer for Wyoming Medicaid. “I see a future in which immunization rates go up, and chronic diseases are managed more proactively.”

To work toward this future, Bush is partnering with Wendy Braund, MD, MPH, State Health Officer and Senior Administrator, Public Health Division of the Wyoming Department of Health. Together they are creating awareness in Wyoming of the ways clinical care and public health can share data to improve population health.

National legislation has paved the way for these changes. In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act was passed. A primary intent of the bill was to promote health information technology. To do this, Medicaid providers were offered incentives to use electronic health records (EHRs) to record patient data.

Most practicing physicians in Wyoming are Medicaid providers. This is largely because Wyoming is the nation’s least populous state, and doctors in Wyoming naturally serve a wider cross-section of the population than they might serve in other states. Wyoming Medicaid has a program in place for all Medicaid providers that gives access, at no cost, to an EHR system called the Total Health Record.

The promotion of EHRs along with reform provisions in the Affordable Care Act that encourage the collaboration of clinical care with public health have naturally paved the way for the creation of health information exchanges in Wyoming. Medicaid has had a functioning health information exchange for over four years that links various Wyoming Department of Health databases such as Medicaid claims and immunization data with the Total Health Record. Data available through this exchange is currently being used to improve the public’s health in Wyoming.

In the future, the state-wide health information exchange, MyWYHealth, will connect with the Medicaid health information exchange. When this happens, every provider in Wyoming will be able to share and submit information. Also, there is a state-level registry that providers who are certifying for meaningful use will be able to download to report on clinical quality measures.

These activities will create a uniform workflow through the entire health care system, not just the parts of it that are accessed by Medicaid and Medicare patients. Eventually, data from the state-level registry will provide a wealth of information about the health status of all Wyoming residents.